COVINGTON - As many as 200 people may have been exposed to tuberculosis by Anthony Underwood, the 32-year-old man who was jailed earlier this month for refusing to comply with his treatment plan, according to a spokesman for the East Metro Health District.
About 125 of those people were exposed in Newton County, said Spokesman Vernon Goins, including seven children living at Underwood's residence at 170 Heritage Way.
The health department is attempting to track all those Underwood came in contact with during the past three months, Goins said, adding that the process is a "labor-intensive operation."
The department is working with other health districts to track contacts outside East Metro's jurisdiction, which covers Newton, Rockdale and Gwinnett counties.
"We have to go back three months from the time he was confirmed to be infectious and check where he's been and everybody he's come into contact with, and we have to treat all those people as a precaution," Goins said.
So far, none of the contacts have tested positive for infection, Goins said.
Tuberculosis testing is done in three stages: A skin test; chest X-ray and testing of sputum or phlegm from deep inside the lungs. If the sputum test is positive, the patient is considered contagious, Goins said.
"A skin test does not indicate that it is in the lungs. It doesn't even mean it's in the body anymore. Just because a person has been exposed, they are definitely not contagious," he said.
Chest X-rays on two of the children living at Underwood's house came back positive, while the other children have had positive skin tests, indicating exposure, Goins said.
"None of them are infectious," he said.
The ages of the children were not available at press time. Goins said no affected children attend day care and emphasized that none of the school-aged children have active cases of TB.
The children will be on drug therapy supervised by the health department for nine months, Goins said.
The Citizen has filed an open records request with the East Metro Health District seeking more information, including the ages and genders of all individuals that have been exposed; how they came into contact with Underwood; the names of any public and private facilities including schools or day care facilities any children who have been exposed may attend; and information on what precautions the health department has asked those facilities to take.
"We have not been informed by the health department that we have had any students diagnosed with an active case of TB," said Sherri Viniard, director of public relations for the Newton County School System. Viniard said parents with concerns should call the health department.
Goins said "there's no risk at all" that those exposed to the disease could be contagious.
A person can only get infectious tuberculosis by breathing in germs the infected person coughs into the air, according to the Centers for Disease Control and Prevention. Tuberculosis cannot be contracted from someone's clothes, drinking glass, eating utensils, a handshake, toilet or other surfaces where a TB patient has been, according to the CDC.
Goins said the health department is in its first stage of investigation, attempting to track all those exposed and determine if they are in the infectious stage.
In Newton County, Underwood exposed at least 11 family and household members and 14 extended family members and friends, according to the East Metro Health District.
He also exposed 100 people at the Newton County Detention Center and the Newton County Judicial Center during past court appearances and confinement, Goins said.
According to Detention Center records, Underwood was most recently incarcerated for a probation violation in late April.
Goins said the health department was notified by Newton Medical Center of Underwood's condition May 2.
Underwood was released from the hospital May 5 and ordered to remain confined at home and to allow the health department to administer medication until he was no longer contagious, he said.
"We found it too difficult to track him down. He was supposed to be at home. We visited, and there was no one there," Goins said. "Whenever that order is given by the health department and isn't complied with, we have no option except to have that person confined until he is no longer infectious. Our ultimate concern is the safety of the community."
Underwood was arrested May 9.
Lisa Smith, a nurse at the infirmary at the Newton County Detention Center, said he was placed in one of the infirmary's "negative pressure rooms," which are specially designed for those with communicable diseases.
"All the air is sucked up through vents and not released out into the open, so he is in complete isolation," she explained. "Any time staff members enter the room, we have on masks."
Goins said Underwood's release will be contingent upon his agreement to self-isolate and cooperate with the health department.
Because he has an advanced case of tuberculosis, Underwood is being treated with more potent drugs than are those he exposed to the disease, Goins said. His drug therapy is expected to last about four months.
Anyone with questions or concerns can call the East Metro Health District's epidemiology department at 770-339-4260.
Crystal Tatum can be reached at firstname.lastname@example.org.